https://www.ncbi.nlm.nih.gov/pubmed/10424529

ick-borne pulmonary disease: update on diagnosis and management.
Faul JL1, Doyle RL, Kao PN, Ruoss SJ.
Author information
1
Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Palo Alto, CA 94305, USA.
Abstract
Ticks are capable of transmitting viruses, bacteria, protozoa, and rickettsiae to man. Several of these tick-borne pathogens can lead to pulmonary disease. Characteristic clinical features, such as erythema migrans in Lyme disease, or spotted rash in a spotted fever group disease, may serve as important diagnostic clues. Successful management of tick-borne diseases depends on a high index of suspicion and recognition of their clinical features. Patients at risk for tick bites may be coinfected with two or more tick-borne pathogens. A Lyme vaccine has recently become available for use in the United States. Disease prevention depends on the avoidance of tick bites. When patients present with respiratory symptoms and a history of a recent tick bite or a characteristic skin rash, a differential diagnosis of a tick-borne pulmonary disease should be considered. Early diagnosis and appropriate antibiotic therapy for these disorders lead to greatly improved outcomes.

Comment in
Ehrlichiosis in the United States. [Chest. 2000]

PMID: 10424529 DOI: 10.1378/chest.116.1.222
[Indexed for MEDLINE]
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Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report
Hien Nguyen, Connie Le, and Hanh Nguyen

Additional article information

Abstract
Introduction
Dermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later.

Case presentation
We present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease.

More at this link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898701/

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CrystalRiver